ABSTRACT
After working in the emergency room for several years, I began to suspect that most of the patients I was seeing there who had been previously diagnosed with bipolar disorder did not have this mental illness. The feel and gestalt of their stories led me to believe that their psychological and physiological “lesions” did not go that deep. When I asked my reputed bipolar patients if they had ever felt, thought, or behaved in ways that would satisfy the DSM-IV criteria for hypomania or mania, perhaps one in five responded affirmatively. The others often sent back looks of disbelief. When I asked if they thought they had bipolar disorder, I got this spectrum of answers: Yes … That’s what the doctor said … I don’t know … You’re the doctor, you tell me … No. Most of these patients had little insight into what their real problems were or what they could be doing to help themselves. That they had been misdiagnosed did not seem to concern them at all.
